Getting to the Heart of the No. 1 Killer of Women

Like a lot of women, Beth Garcia didn’t think too much about it when struck by a sudden sharp pain in her chest. “It didn’t occur to me at all that I was having a heart attack,” said Garcia, a 41-year-old mother of two with no family history of heart disease. “I just figured it would pass.”

The pain occurred in 2010 just as Garcia and her husband sat down for a nice dinner in Coronado with her husband’s twin brother, who was visiting from out-of-town. “Then I started having pain in my jaw and in my neck. The waiter brought the food and I got really nauseous.”

She didn’t want to disrupt her husband’s dinner with his brother. “I had company at the dinner table. I thought, ‘yeah, it hurts, but it wasn’t going to throw me on the floor.’ I just brushed it off. I think that’s why a lot of women die from heart disease. They just blow it off.”

Such is the conundrum of heart disease, especially for women: The symptoms are often hard to recognize and women have a tendency to ignore them.

“Studies have shown that women are more likely to disregard their symptoms than men,” said
Lori Daniels, MD, director of the Coronary Care Unit at
Sulpizio Cardiovascular Center at UC San Diego Health. “I think women are inclined to think, ‘Oh that pain will just go away.’ Or they don’t want to make a big fuss about nothing. My thinking is, ‘So what if it’s a false alarm? If you have concerns, we have concerns. We’re here to help you.”

Know the Signs (Some of which you’d never suspect!)

Some signs of coronary heart disease and heart attack in men and women are the same, but a number are different and some symptoms show up in unsuspecting ways.

“Overall there are probably more similarities than differences between men and women’s symptoms,” said Daniels, who is a professor in UC San Diego School of Medicine’s Division of Cardiovascular Medicine. “Just like with men, chest discomfort is still the most common symptom of heart disease and heart attack in women.”

The chest pain or discomfort, known as angina, occurs when the heart muscle isn’t getting enough oxygen-rich blood. “It’s often described more as a heaviness than a pain,” said Daniels. “The discomfort commonly radiates to the arm or neck.” But in some women – estimates run as high as half – chest pain may not occur. “Some women may only have neck pain and no chest pain,” said Daniels, who became Garcia’s cardiologist in 2013. “Or their chest pain may be secondary or much less than their neck pain.”

Other symptoms more common in women include:

Jaw pain. This can also be associated with neck pain that may radiate from the neck to the jaw. Women are also more likely to have pain in the throat, abdomen or back.

Heartburn. “This is a really important one,” said Daniels. “I’ve had both men and women diagnose themselves or have doctors diagnose them with heartburn or reflux, but it was really angina.”

Fatigue.

Nausea. Flu-like symptoms may be experienced weeks and days before a heart attack. Vomiting and lightheadedness may also occur.

Shortness of Breath. This can occur when resting or doing a little bit of physical activity and may manifest as the only symptom.

A healthy and active mother of two survives a major heart attack after receiving life-saving care at UC San Diego Health. Heart disease is the leading killer of women in the United States, yet about 200,000 deaths could be prevented each year. Watch this mother’s compelling story and the signs that may indicate your heart is in trouble.

Daniels said heart attacks have similar symptoms to coronary heart disease in general. “A heart attack is just a prolonged and often more severe version of the symptoms of coronary heart disease, which is narrowing of the arteries that feed the heart,” she said. For instance, a gnawing discomfort in the chest that’s there for a couple of minutes, especially if it gets better with rest and worse with exertion, could indicate underlying coronary heart disease. If it doesn’t go away, especially if it is particularly severe, it could indicate a heart attack.

In Garcia’s case, the chest pain didn’t match her idea of what a heart attack would feel like. “The symptoms fooled me in the sense that I could still function,” she said. “I didn’t have radiating pain down my arms. I wasn’t incapacitated. It felt like I was getting a Charlie horse in a muscle.”

Even so, Garcia finally acknowledged to family gathered at the restaurant that she wasn’t feeling well. They packed up the food and headed home. Garcia phoned her doctor about her symptoms and an ambulance was soon on its way. By this time, she’d been suffering from her chest pain, jaw pain and nausea for nearly two hours. Then suddenly she felt better.

When the paramedics arrived, they found a woman whose symptoms had passed. “I think they thought I’d had an anxiety attack or something.” She didn’t go to the hospital that night, but was ultimately diagnosed with an 85 percent occlusion in a main artery. “I had actually had a major heart attack,” she said.

An arterial stent was implanted to repair the blockage. Garcia, now 47, has recovered well and lives life with the “stop and smell the roses” approach of one who has faced a life-threatening experience. She also uses her experience to help others. “Now, I tell people don’t ignore a pain that you know is not typical for you. Have it checked out. Don’t wait.”